Over the last four decades, both the public and private sectors have experimented with payment approaches designed to change provider behavior, motivating providers to deliver better care at lower cost.
Since the RAND Health Insurance Experiment, RAND Health has led the way in efforts to understand the links between physician payment, quality of care, and system cost.
RAND piloted proposed G-codes to determine whether doctors understood and correctly applied the codes. Using vignettes to test coding accuracy, researchers made recommendations for refining coding instructions.
There are many challenges in measuring quality of care for seriously ill patients. Potential solutions to improve community-based programs that treat these patients include engaging in communication, shared decisionmaking, and advance care planning.
RAND researchers used the RAND Health Care Payment and Delivery Simulation Model (PADSIM) to estimate how sensitive physician behavior is to the design of alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA).
The New Jersey state legislature is debating proposals to limit payments for involuntary out-of-network care. Researchers analyzed the role of these payments in hospitals' financial performance and simulated the effect of policies limiting such payments.